Job Description
Job Description
Job Description
Benefits:
- 401(k)
- 401(k) matching
- Company parties
- Dental insurance
- Health insurance
- Opportunity for advancement
- Paid time off
- Training & development
- Vision insurance
Position Overview
The ICD-10 Home Health & Hospice Medical Coder is responsible for accurately reviewing, analyzing, and assigning ICD-10-CM diagnosis codes to clinical documentation for home health and hospice services. This role ensures compliance with CMS guidelines, OASIS requirements, and agency policies to support precise reimbursement, high-quality patient care, and regulatory compliance.
The ideal candidate has demonstrated experience in
Home Health ICD-10 coding , strong knowledge of OASIS/Evaluation criteria, and a thorough understanding of PDGM (Patient-Driven Groupings Model).
Key Responsibilities Coding & Documentation Review - Review clinical documentation to identify appropriate and accurate ICD-10-CM codes for home health and hospice encounters.
- Assign primary and secondary diagnoses following CMS, PDGM, and regulatory requirements.
- Validate medical necessity and ensure coding supports the plan of care and services rendered.
- Review and interpret physician orders, clinical notes, OASIS assessments, and other documentation to ensure accurate code selection.
Quality, Compliance & Auditing - Ensure all coding aligns with CMS, industry, and agency standards, including PDGM/PEPPER guidelines.
- Conduct self-audits or participate in agency coding audits to maintain accuracy and compliance.
- Assist with corrections and updates based on audit findings or regulatory changes.
- Maintain strict confidentiality and follow HIPAA requirements.
Collaboration & Communication - Communicate with clinicians, QA staff, and the billing department to clarify diagnoses, resolve documentation discrepancies, and improve coding accuracy.
- Provide feedback to clinical staff regarding documentation gaps that impact coding or reimbursement.
- Participate in training or educational sessions to enhance coding competency and knowledge of industry updates.
Data Integrity & Workflow Management - Complete coding assignments within established departmental timelines.
- Ensure accurate and timely submission of coded encounters for billing and compliance.
- Assist in optimizing coding workflows, documentation processes, and clinical data accuracy.
Required Qualifications - Minimum 2 years of Home Health ICD-10 coding experience (required).
- Certification from a recognized credentialing body such as:
- HCS-D (Home Care Coding SpecialistDiagnosis) preferred
- CPC , CCS , COC , or RHIT/RHIA accepted with Home Health-specific experience
- Strong understanding of PDGM , OASIS documentation requirements, and Medicare regulations.
- Experience with home health EMR systems (e.g., Homecare Homebase, WellSky/Kinnser, MatrixCare).
- Excellent analytical, critical-thinking, and documentation review skills.
- Strong understanding of pathophysiology, medical terminology, and clinical documentation requirements.
Preferred Qualifications - Hospice coding experience (ICD-10-CM) strongly preferred.
- Knowledge of HIS (Hospice Item Set) and hospice regulatory requirements.
- Experience working remotely or in a high-volume coding environment.
- Familiarity with PEPPER reports and quality metrics for home health agencies.
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